Determination of risk factors for the development of tuberculosis with drug-resistant strains of Mycobacterium tuberculosis in the Arkhangelsk oblast, Russia

DESIGN: Strains isolated from 119 patients with pulmonary tuberculosis were studied by the BACTEC method. Medical records of the patients were reviewed, retrospectively, to identify factors associated with drug resistance. RESULTS: Sixty-seven strains (56.3%) were resistant to at least one antituberculosis drug. Thirty of the 119 strains (25.2%) were multi-drug resistant. All strains resistant to rifampicin were multi-drug resistant. Multidrug resistance was four times more common among previously treated patients than among new patients. The highest rates of drug resistance were observed for streptomycin and isoniazid. 40.4% and 66.7% of strains collected from new and previously treated patients were resistant to streptomycin, respectively. 37.1% and 73.3% of strains collected from new and previously treated patients were resistant to isoniazid, respectively. A history of previous or interrupted treatment for tuberculosis and being female were significantly associated with resistance to at least one anti-tuberculosis drug and multidrug resistance. CONCLUSION: Drug-resistant tuberculosis is an important problem in the Arkhangelsk oblast, Russia. The spread of drug-resistant strains of M. tuberculosis is attributed to several risk factors. A history of previous or interrupted treatment for tuberculosis and being female are significantly associated with resistance to at least one anti-tuberculosis drug and multidrug resistance. Employment in the health sector of Arkhangelsk was significantly associated with the development of drug resistance